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Provider Directory API Specification

Provider Directory API Overview

Welcome to our Provider Directory API, designed in compliance with the CMS 9115-F regulations. This API facilitates secure and efficient access to a health insurer’s plan and network data, utilizing the HL7® FHIR® R4 standard, a globally recognized framework for health care information exchange.

What is an API?

API stands for “Application Programming Interface” and is a way for an application to interact with a server on the internet. The Provider Directory API allows an application to access a health insurer's plans, associated networks, and the organizations and providers participating in these networks.

Capability Statement

The FHIR Capability Statement documents the behaviors of the FHIR server for a particular version of the FHIR standard. For more information, consult the official specificationOpens in a new tab.

Connecting Your Application

To connect your application to the Provider Directory API, you will need to ensure that your application supports the following standard:

Implementation Guides

The Provider Directory API FHIR endpoint is configured using the following implementation guides:

Authentication

Use of the Provider Directory API does not require authentication as stipulated by the Plan Net implementation guide.

Profiles and Resources

The following list describes the resources currently supported:

Profile Resource
PlannetEndpointOpens in a new tab Endpoint (R4)Opens in a new tab
PlannetPractitionerOpens in a new tab Practitioner (US Core)Opens in a new tab
PlannetPractitionerRoleOpens in a new tab PractitionerRole (R4)Opens in a new tab
PlannetOrganizationOpens in a new tab Organization (US Core)Opens in a new tab
PlannetOrganizationAffiliationOpens in a new tab OrganizationAffiliation (R4)Opens in a new tab
PlannetHealthcareServiceOpens in a new tab HealthcareService (R4)Opens in a new tab
PlannetInsurancePlanOpens in a new tab InsurancePlan (R4)Opens in a new tab
PlannetLocationOpens in a new tab Location (US Core)Opens in a new tab
PlannetNetworkOpens in a new tab Organization (US Core)Opens in a new tab
FeedbackOpens in a new tab